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Carbapenemase-Producing Enterobacteriaceae and Nonfermentative Bacteria, the Philippines, 2013-2016

John Mark Velasco, Maria Theresa Valderama, Trent Peacock

    Emerging Infectious Diseases
    |August 19, 2017
    PubMed

    Insights

    Carbapenem-resistant bacteria carrying New Delhi metallo-β-lactamase (NDM) and Verona integron-encoded metallo-β-lactamase (VIM) genes were found in the Philippines. Enhanced surveillance and antimicrobial stewardship are crucial to control the spread of these multidrug-resistant pathogens.

    Area of Science:

    • Microbiology
    • Infectious Diseases
    • Antimicrobial Resistance

    Background:

    • The emergence of carbapenem-resistant Enterobacteriaceae (CRE) and nonfermentative bacteria poses a significant global health threat.
    • Metallo-β-lactamase (MBL) enzymes, such as New Delhi metallo-β-lactamase (NDM) and Verona integron-encoded metallo-β-lactamase (VIM), are key mechanisms of carbapenem resistance.
    • Limited data exist on the prevalence and types of MBL-encoding genes in the Philippines.

    Purpose of the Study:

    • To investigate the presence and characteristics of carbapenemase-producing Enterobacteriaceae and nonfermentative bacteria in clinical isolates from the Philippines.
    • To identify the specific metallo-β-lactamase genes (blaNDM and blaVIM) responsible for carbapenem resistance.
    • To inform strategies for controlling the spread of multidrug-resistant pathogens.

    Main Methods:

    • Prospective isolation of carbapenem-resistant bacteria from patients between 2013 and 2016.
    • Phenotypic detection of carbapenemase activity using the Carba NP test.
    • Molecular detection of blaNDM and blaVIM genes using PCR or sequencing.

    Main Results:

    • A total of 130 carbapenem-resistant isolates were collected.
    • 45 isolates tested positive in the Carba NP test, indicating carbapenemase production.
    • Of the Carba NP-positive isolates, 43 harbored the blaNDM gene, and 2 harbored the blaVIM gene.

    Conclusions:

    • The study identified the presence of blaNDM and blaVIM genes in carbapenem-resistant bacteria from the Philippines.
    • New Delhi metallo-β-lactamase (NDM) appears to be the predominant carbapenemase among the studied isolates.
    • Enhanced surveillance of multidrug-resistant pathogens and robust antimicrobial drug stewardship programs are essential to curb the dissemination of these resistance genes.
    Keywords:
    EnterobacteriaceaeNew Delhi metallo-β-lactamase–producingantimicrobial resistancebacteriacarbapenem-resistantcarbapenemase-producingenteric infectionsmilitary treatment facilitymultidrug resistancenonfermentative bacteriathe Philippines

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